Diffuse primary malignant melanoma of the upper gastrointestinal tract.

Primary malignant melanomas of the GI tract are very rare. Their symptomatology is not specific. We report a 78-year-old Tunisian woman hospitalised with a 6-month history of recurrent abdominal pain, loss of appetite, weakness and weight loss.

Bilateral ovarian serous borderline tumor with a giant non-invasive peritoneal implant in a four-year-old girl.

Epithelial ovarian tumors are uncommon before 20 years of age and rarely occur before puberty. The vast majority of these tumors are benign, and few cases of malignant and borderline tumors are described. We report a case of a 4-year-old premenarchal girl, previously healthy, who presented with two abdominal masses.

Murine neonatal infection provides an efficient model for congenital ocular toxoplasmosis.

Congenital infection is one of the most serious settings of infection with the apicomplexan parasite Toxoplasma gondii. Ocular diseases, such as retinochoroiditis, are the most common sequels of such infection in utero. However, while numerous studies have investigated the physiopathology of acquired toxoplasmosis, congenital infection has been largely neglected so far.

Cognitive features in euthymic bipolar patients in old age.

Objectives: Studies of cognition in bipolar disorder (BD) have reported impairments in processing speed, working memory, episodic memory, and executive function, but they have primarily focused on young and middle-aged adults. In such studies, the severity of cognitive deficits increases with the duration of illness. Therefore, one would expect more pronounced deficits in patients with longstanding BD.

Prospective evaluation of prostate cancer risk in candidates for inguinal hernia repair.

Background: Preperitoneal placement of mesh during herniorraphy has been shown to complicate future extirpative prostate surgery. We investigated the value of a prostate cancer screening program in patients considering laparoscopic inguinal herniorrhaphy to identify men at risk of prostate cancer.

Study Design: A prospective cohort study was conducted in men 30 years of age or older presenting with inguinal hernia.

A nomogram for predicting upgrading in patients with low- and intermediate-grade prostate cancer in the era of extended prostate sampling.

Study Type: Diagnostic (exploratory cohort).

Level Of Evidence: 2b.

Objective: To develop a nomogram to predict the probability that the pathological Gleason sum (GS) will be higher than that indicated by the biopsy, suggesting a higher risk for the patient presumed to be at low risk, as a substantial proportion of patients with low and intermediate grade on biopsy are upgraded on interpretation of the radical prostatectomy (RP) specimens, but a similar clarification of accurate Gleason scoring is not available in patients with no surgical histology.

Shoulder arthritis as a lung metastatic carcinoma revealer. A case report.

Joint metastasis is very rare. It usually presents as a monoarthritis. It is generally located in the knee and secondary to lung cancer.

Three questions to screen for postdischarge surgical site infections.

In-hospital surveillance of surgical site infections (SSI) was conducted on 599 patients in a German university hospital. On a subgroup of 342 patients, SSI was assessed after discharge from hospital based on data of a questionnaire and telephone interviews. Postdischarge surveillance revealed substantially higher infection rates than in-hospital surveillance.

Endoscopic ultrasonography versus helical CT in diagnosis and staging of pancreatic cancer.

Aim: Compare the performances of EUS to helical CT in the diagnosis and staging of pancreatic adenocarcinoma.

Methods: Forty two consecutive patients (mean age 63 years; 25 men, 17 women) who had surgical exploration and histologically proved pancreatic cancer were retrospectively included. All our patients underwent with endoscopic ultrasonography (EUS) and helical computed tomography (helical CT).

Characterisation of spinal cord in a mouse model of spastic paraplegia related to abnormal axono-myelin interactions by in vivo quantitative MRI.

In inherited neurodegenerative disorders the engineering of genetically modified mice for the causative genes have provided new insights in the understanding of axono-glial interactions. Patients lacking the major proteins of the central nervous system myelin, the proteolipoproteins (PLP1) exhibit an ascending axonopathy, named spastic paraplegia type 2. Our objective was to examine the interest of using quantitative MRI for non invasive detection of spinal cord (SC) consequences of the PLP1 defect in a mouse model of SPG2 (PLP1-/Y).

Simultaneous occurrence of two squamous cell carcinomas within a nevus sebaceous of Jadassohn in an 11-year-old girl.

The development of a squamous cell carcinoma within a nevus sebaceous of Jadassohn is very rare. We report here for the first time, the simultaneous occurrence of two squamous cell carcinomas within a single nevus sebaceous of Jadassohn.

[How to become a good pediatrician: a balance between theoretical and clinical training].

We review a different way of teaching medicine and pediatrics which balances theory and clinical training for undergraduate, postgraduate and during continuing education. We also discuss the role of the teacher. We recommend better evaluation of students and teacher assessments.

[Isolated extramedullary adnexal relapse of acute lymphoblastic leukemia: a case report].

The occurrence of an isolated ovarian or pelvic relapse of acute lymphoblastic leukemia (ALL) in complete remission after chemotherapy has rarely been described. We report the case of a 12-year-old girl, treated for ALL, who developed an isolated left ovarian and fallopian tube localization without medullary or blood relapse 4 years after the end of the initial treatment. She presented with an isolated pelvic mass.

Prevalence of subclinical amyloidosis in Tunisian patients with rheumatoid arthritis.

Introduction: Secondary amyloidosis is a serious complication of rheumatoid arthritis (RA). Symptoms are late to occur, so that screening is in order, most notably in patients with long-standing RA. The objectives of our study were to determine the prevalence of subclinical amyloidosis in RA patients by abdominal fat aspiration biopsy (AFAB) and minor salivary gland biopsy (MSGB) and to identify factors associated with subclinical amyloidosis.

Does transrectal ultrasound probe configuration really matter? End fire versus side fire probe prostate cancer detection rates.

Purpose: We compared prostate cancer detection rates for the 2 most commonly used transrectal ultrasound prostate biopsy probes, end fire and side fire, to determine whether the probe configuration affects detection rates.

Materials And Methods: We evaluated 2,674 patients who underwent initial prostate biopsy between 2000 and 2008 with respect to prostate specific antigen, biopsy technique and pathological findings. Patients were divided into 1,124 in whom biopsies were performed with an end fire probe and 1,550 in whom biopsies were performed with a side fire probe.

Bilateral adrenalectomy for severe hypertension in congenital adrenal hyperplasia due to 11beta-hydroxylase deficiency: long term follow-up.

Context: Bilateral adrenalectomy has been recently proposed as a surgical treatment option for patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. There is however little documented data about the long-term efficiency and potential side effects of this treatment. Patients with 11beta-hydroxylase deficiency (11betaHD) have been also concerned by this new approach.

Binding of IgA by Mycoplasma penetrans.

The current study shows that Mycoplasma penetrans strain GTU binds human serum immunoglobulin A (IgA) and secretory IgA but not IgG. Binding of IgA was associated almost exclusively with the lipoprotein fraction obtained by Triton X-114 fractionation of isolated M. penetrans membranes.

Laparoscopic cystoprostatectomy for radiation-induced hemorrhagic cystitis.

Background And Purpose: Hemorrhagic cystitis after radiotherapy is a relatively rare event, usually occurring several years after radiation treatment. It can be relentlessly progressive, and treatment options are usually suboptimal. No management strategy is fully successful, and a stepwise progression in treatment intensity is often necessary with cystectomy and urinary diversion being the final management option.

3020insC insertion in NOD2/CARD15 gene, a prevalent variant associated with anti-Saccharomyces cerevisiae antibodies and ileal location of Crohn's disease in Tunisian population.

Objective: Our aim is to investigate the relation between CARD15 3020insC mutation, anti-Saccharomyces cerevisiae antibodies (ASCA) and disease phenotype, in Tunisian inflammatory bowel disease (IBD) patients.

Materials: A hundred Tunisian patients with IBD (75 Crohn's disease CD and 25 ulcerative colitis UC) and 60 matched healthy controls were studied.

Methods: CARD15 mutation was analysed by using an allele-specific polymerase chain reaction and sequencing.

Interleukin 10 promoter region polymorphisms in inflammatory bowel disease in Tunisian population.

Objective: To test whether IL-10 promoter region polymorphisms are associated with susceptibility to inflammatory bowel disease, we examined the contribution of interleukin- 10 (IL-10) gene polymorphisms to Crohn's disease (CD) and Ulcerative colitis disease (UC) occurrence and also to CD phenotype. MATERIELS AND METHODS: SNPs at positions -627 (C > A) and -1117 (G > A) in the IL-10 promoter were determined in a sample of 105 Tunisian patients with IBD (75 CD and 30 UC) and 90 matched healthy controls.

Results: The 627 CA genotype is associated with ileal location (p = 0.

Self-healing Langerhans cell histiocytosis (Hashimoto-Pritzker disease): two Tunisian cases.

Self-healing Langerhans cell histiocytosis (SHLCH) is a rare self-limited variant of Langerhans cell histiocytosis that presents at birth or during the neonatal period. It was first described by Hashimoto and Pritzker in 1973. Subsequently, more than 70 cases have been reported in the literature.

Prevalence of mutations in APC, CTNNB1, and BRAF in Tunisian patients with sporadic colorectal cancer.

Sporadic colorectal tumorigenesis is caused by alterations in the Wnt (APC, CTNNB1) and Ras pathways. Our objective was to analyze the occurrence of these genetic alterations in relation to tumor and patient characteristics. The prevalence of somatic alteration in the hot-spot regions of the APC, BRAF, and CTNNB1 genes was investigated in 48 unselected and unrelated Tunisian patients with sporadic colorectal cancer, and the association between the molecular features at these genes in relation to tumor and patient characteristics (age at diagnosis, sex, tumor localization, stage, and differentiation) was analyzed.

Identification and characterization of a novel MLH1 genomic rearrangement as the cause of HNPCC in a Tunisian family: evidence for a homologous Alu-mediated recombination.

High rates of early colorectal cancers are observed in Tunisia suggesting high genetic susceptibility. Nevertheless, up to now no molecular studies have been performed. Hereditary nonpolyposis colorectal cancer (HNPCC) is the most frequent cause of inherited colorectal cancer.